How much rates vary
Facilitymedian $2,570 · 10th to 90th $229 to $5,012Professionalmedian $138 · 10th to 90th $105 to $209
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,000.00 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,000.00 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $218.78 | Professional | None | $131.83 | $173.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $199.53 | Professional | None | $120.23 | $141.25 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $213.80 Typical High $302.00 | Professional | 50 · Both sides | $181.97 | $213.80 | $302.00 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | None | $165.96 | $165.96 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $371.54 | Facility | None | $100.00 | $177.83 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $257.04 | Professional | None | $93.33 | $117.49 | $257.04 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $407.38 | Facility | None | $95.50 | $125.89 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $263.03 | Professional | None | $131.83 | $169.82 | $263.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $190.55 | Professional | None | $79.43 | $123.03 | $190.55 |
Fidelis Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $173.78 | Professional | None | $66.07 | $87.10 | $173.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $407.38 | Professional | None | $134.90 | $186.21 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $218.78 | Professional | None | $104.71 | $104.71 | $218.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $204.17 | Professional | None | $93.33 | $128.82 | $204.17 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $131.83 Typical High $338.84 | Facility | None | $112.20 | $131.83 | $338.84 |
Univera Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $190.55 | Professional | None | $79.43 | $131.83 | $190.55 |
17 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $70.79 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $104.71 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $97.72 | $112.20 | $125.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $123.03 | $169.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $19.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $19.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $109.65 | $151.36 |
Fidelis Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $87.10 Typical High $87.10 | Professional | 51 · Multiple procedures | $60.26 | $87.10 | $87.10 |
Highmark BCBS Setting Facility Modifier 51 · Multiple procedures Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | 51 · Multiple procedures | $54.95 | $54.95 | $54.95 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $74.13 | $93.33 | $128.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $123.03 | $169.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $28.18 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $28.18 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $28.18 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $28.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $109.65 | $151.36 |
Where New York sits
The same service costs 4.1 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 39th of 51
$141
AK $468FL $115
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.